A child presents with abdominal pain only during passage of stools. No other symptoms like vomiting or blood in stools. There are no signs of intestinal obstruction. Most probable diagnosis is?
(Ref. Bailey and Love 25th/pg. 1228)
A child presents with abdominal pain only during passage of stools. No other symptoms like vomiting or blood in stools. There are no signs of intestinal obstruction. Most probable diagnosis is Rectal polyp.
C/f of rectal polyp:
a. Intermittent painles rectal bleeding is the most common presentation
b. Rectal bleeding occurs during defecation.
c. Iron deficiency anemia is found in as many as 1/3rd of patients.
d. Rectal bleeding is recurrent, present for over 3 months in 55% of cases.
e. Additional manifestations are ususal, including colicky abdominal pina, diarrhea with mucus, autoamputation with spnataneous extrusion, proplaspe of rectal polyp, and prolapse of rectum.
f. Colocolic intussusception is rare.
C/f of Intussusception:
a. Intussusception is telescoping of one portion of the intestine (intussusceptum) into an adjacent segment (intussuscipiens), causing intestinal obstruction and sometimes intestinal ischemia.
b. Intussusception is the most common abdominal emergency in children younger than 2 years of age.
c. Intussusception usually occurs in patients 4 to 10 months of age, with 65% of cases occurring before 1 year and 80% by 2 yrs of age.
d. It is the most common cause of intestinal obstruction in this age group.
e. Most cases are idiopathic.
f. Episodic colicky abdominal pain with vomiting, followed by passage of “red-currant jelly stool”, is typical feature.
g. Differentiating features of intussusception include ill appearance of the child in acute cases.